Boulloche J, Slim S, Le Luyer B, Mallet E, Tron P, Le Roux P, Lienhardt P Y, Coudray C
Département de Pédiatrie, Centre Hospitalier du Havre.
Arch Fr Pediatr. 1993 May;50(5):387-9.
As facial nerve palsy is usually of sudden onset and of obscure etiology, a survey of large series may provide new information.
The files of 40 children suffering from acute facial nerve palsy seen in 3 pediatric and 1 otorhinolaryngologic (ORL) departments between 1980 and 1990 were analysed. Patients with congenital palsy and those with paralysis that appeared after injury or in the course of acute or chronic disease (otitis media, tumor) were excluded from the study. The children were 9 months-16 years old (mean: 7 year 1 month). There were 22 left and 18 right facial nerve palsies. The palsy was moderate in 17 children, severe in 15, and total in 5. Etiologic factors (viral serologic studies, CSF examination), ORL studies and electromyogram of the facial nerve were analyzed in the majority of cases. Corticosteroids were used in 30 patients.
A viral etiology was suspected and/or confirmed in 13 children; abnormalities were seen in 6 of the patients who underwent lumbar puncture. A familial facial nerve palsy was seen in 1 case and kidney disease in 2 cases. 23 cases appeared to be idiopathic. A moderate permanent residual weakness was seen in only 4 children. The mean time for recovery was 32 days (4-140 days). Corticosteroids did not influence the incidence of complete recovery, but decreased the time for recovery (26 versus 37 days) only in the patients who were treated before the 3rd day of the disease. Patients with idiopathic palsy recovered 23 days before those with viral etiology.
Idiopathic and post-viral facial nerve palsies seem to have an excellent prognosis. Corticosteroids seem to have no effect although there is some evidence of benefit when treatment is begun early.
由于面神经麻痹通常起病突然且病因不明，对大量病例的调查可能会提供新的信息。
分析了1980年至1990年间在3个儿科和1个耳鼻喉科（ORL）科室就诊的40例急性面神经麻痹儿童的病历。先天性麻痹患者以及损伤后或急性或慢性疾病（中耳炎、肿瘤）过程中出现麻痹的患者被排除在研究之外。这些儿童年龄在9个月至16岁之间（平均：7岁1个月）。左侧面神经麻痹22例，右侧18例。17例儿童为中度麻痹，15例为重度麻痹，5例为完全麻痹。大多数病例分析了病因学因素（病毒血清学研究、脑脊液检查）、耳鼻喉科检查和面神经肌电图。30例患者使用了皮质类固醇。
13例儿童疑似和/或确诊为病毒病因；6例接受腰椎穿刺的患者出现异常。1例为家族性面神经麻痹，2例为肾病。23例似乎为特发性。仅4例儿童出现中度永久性残留无力。平均恢复时间为32天（4 - 140天）。皮质类固醇不影响完全恢复的发生率，但仅在疾病第3天之前接受治疗的患者中缩短了恢复时间（26天对37天）。特发性麻痹患者比病毒病因患者提前23天恢复。
特发性和病毒感染后面神经麻痹似乎预后良好。皮质类固醇似乎没有效果，尽管有证据表明早期开始治疗有益。
